Sleep disorders as risk factors for calcific aortic stenosis

Background Circadian disruption and sleep disorders have been shown to increase the risk for many cardiovascular diseases. Their association specifically with valvular heart disease, however, is inconclusive. Methods We leveraged large electronic health record datasets (the TriNetX network and the All of Us study) to test whether sleep disorders are a risk factor for calcific aortic stenosis (AS). We fitted Cox proportional hazards models to quantify the risk of future incidence of AS in patients with sleep disorders. We also explored clinical laboratory test datasets for biochemical signals that might explain the association, running mediation analyses. Results In our fully adjusted Cox models, we find that having any sleep disorder increases the risk for the future incidence of AS (HR: 1.15 95% CI: 1.13-1.18). Changes in lipid profile mediate a proportion of that association. Conclusion Sleep disorders are associated with an increased risk of AS incidence. That association is independent of classical cardiovascular risk factors even though dyslipidemia plays a large role in mediating this risk.